[S.T.A.C.E.Y]

My advice: Run through it in your head! Step by step, everything you will do if:
- you walk into the patient's room and they're unresponsive on the bed.
- you walk into the patient's room and they're unresponsive in the bathroom.
- you hear another nurse call for help down the hall and its HER patient thats unresponsive.
- you hear a code blue called for the next unit over, and you show up to help.
- you're transferring a patient and the patient goes unresponsive in the elevator

etc, etc, etc.

Run through it in your head over and over again. This is what I do frequently with things which I fear I will not react instinctively for.

Oh, and go to every code you can.....even if its just to watch. You'll eventually get a good idea what goes next. ACLS is great too, but you'll lose it if you dont use it.

And don't forget that like a previous poster said.....most dead people STAY dead, despite our best efforts.

[Spatialized]

First of all, take a deep cleansing breath and blow it out. Feel better?

Now like "rbezemek" said, we're trying to avoid codes, sometimes though it's not possible. As you get further into practice you'll start noticing the "intangibles", those things that just don't feel right and start acting with your gut. Usually, we know when a patient is going south, but aren't convinced. Get help. Use other RNs, your charge nurse and start lobbying your hospital for a Rapid Response Team. They're going to have to anyway to get accredited by JHACO as RRTs are a new Patient Safety Goal for 2008, so it never hurts to get them on the road.

As for codes, the first I was in I ran into the room with the cart and my mind went completely blank...instinct went out the window. It's gotten better since then. ACLS guidelines are now more simplified than they used to be. Good BLS is the basis, everything else is just extra. But learn it and you'll feel better knowing that you've seen the scenarios, even if you don't have the algorithms memorized.

As for mortality, just to throw y'all off, the last 2 codes on my floor both came out of it just fine. The others I've been in though, not so much. My knees and back still hurt from the last one...

Cheers,
Tom

[brealynn]

I'm a new graduate nurse and in clinical a few weeks ago there was a code in the ER where I was working. The staff that was doing the code knew this poor lady was already gone, but they asked me to take over with compressions. I freaked and froze up!! I didn't know what to do at all! Didn't know how to place my hands on her chest.....I just really forgot everything I knew. I'm glad they let me participate though, so when a another situation arises, I won't freeze like I did on this day. I felt really stupid!

I hope that during orientation at my new job....they will have mock codes to participate in. I need the practice!

[bearmedicine]

i just had my first code last night and i was momentarily torn between how long was he dead and what his code status was - and then boom i was on the loud speaker saying Code Blue 106 and suddenly cna's and nurse's appeared to help - i also immediately started CPR and the last thing i remember about the whole event is giving the paramedic the pt face sheet at the nurse's station - and then it was back to work...
when i looked back on it at home - i am sure i looked like a deer in the headlights cause that is exactly how i felt...

[firecoins]

Its natural for people to freeze up their first time.